Adverse Event Reporting

VAERS ID 2013330
Gender Male
Age
StateCode FR
Pharmaceutical Company MODERNA
Lot Number
Number of vaccinations 3
Vaccinated 2021-12-13
Onset 2021-12-01
Condition Hospitalized Died
Symptoms
  • Myocardial infarction
  • Apallic syndrome

Current Illness

Preexisting Conditions

Medical History/Concurrent Conditions: Rehabilitation therapy (long term alcohol rehabilitation)

Other Medications

Previous Vaccinations

Allergies

Laboratory Data

Write-up

Heart attack; vegitative state; This spontaneous case was reported by a consumer and describes the occurrence of MYOCARDIAL INFARCTION (Heart attack) and APALLIC SYNDROME (vegitative state) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination.
The patient's past medical history included Rehabilitation therapy (long term alcohol rehabilitation).
Previously administered products included for Product used for unknown indication: Astrazeneca.
Past adverse reactions to the above products included No adverse event with Astrazeneca.
On 13-Dec-2021 at 3:00 PM, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form.
On 14-Dec-2021 at 11:00 AM, the patient experienced MYOCARDIAL INFARCTION (Heart attack) (seriousness criteria death, hospitalization and medically significant).
In December 2021, the patient experienced APALLIC SYNDROME (vegitative state) (seriousness criteria hospitalization and medically significant).
The patient died on 18-Dec-2021.
The reported cause of death was Heart attack.
It is unknown if an autopsy was performed.
At the time of death, APALLIC SYNDROME (vegitative state) outcome was unknown.
At 11 am on 14-Dec2021, the patient was transferred hospital immediately and was hospitalized in intensive care unit.
The hospital reported that it was difficult to conclude that the vaccine may have caused a heart attack.
No concomitant medication details were provided by reporter.
No treatment medication details were provided by reporter.
Company comment: This spontaneous case concerns a male patient of unknown age, with medical history of alcohol problem, who experienced the unexpected, serious (fatal/hospitalization/medically significant) event of myocardial infarction and unexpected, serious (hospitalization/medically significant) event of apallic syndrome.
The patient developed myocardial infarction after 1 day of receiving a dose of mRNA-1273 vaccine, considered as the third dose of the patient's COVID-19 vaccination schedule.
He was admitted to the hospital in the intensive care unit, however he was diagnosed with vegetative state and he died 5 days after vaccination.
Autopsy report is not available.
The patient received as first and second dose of his COVID-19 vaccination schedule two doses AstraZeneca's COVID-19 vaccine.
The hospital reported that it is difficult to conclude that the vaccine may have caused the myocardial infarction.
The rechallenge is not applicable, considering the outcome.
The medical history of alcohol problem remains as a confounder.
The benefit -risk relationship of mRNA -1273 Vaccine is not affected by this report.
; Sender's Comments: This spontaneous case concerns a male patient of unknown age, with medical history of alcohol problem, who experienced the unexpected, serious (fatal/hospitalization/medically significant) event of myocardial infarction and unexpected, serious (hospitalization/medically significant) event of apallic syndrome.
The patient developed myocardial infarction after 1 day of receiving a dose of mRNA-1273 vaccine, considered as the third dose of the patient's COVID-19 vaccination schedule.
He was admitted to the hospital in the intensive care unit, however he was diagnosed with vegetative state and he died 5 days after vaccination.
Autopsy report is not available.
The patient received as first and second dose of his COVID-19 vaccination schedule two doses AstraZeneca's COVID-19 vaccine.
The hospital reported that it is difficult to conclude that the vaccine may have caused the myocardial infarction.
The rechallenge is not applicable, considering the outcome.
The medical history of alcohol problem remains as a confounder.
The benefit -risk relationship of mRNA -1273 Vaccine is not affected by this report.
; Reported Cause(s) of Death: Heart Attack